Strap tightener assembly for an orthopedic device

ABSTRACT

A strap tightener assembly has a base, a tightening device mounted on the base and movable relative thereto, and a strap assembly coupled to the tightening device. The tightening device provides incremental movement of the strap assembly relative to the base at a plurality of predefined settings. A cover extends over the strap assembly and connects to the base so that the base and the cover form a channel permitting movement of the strap assembly therethrough. The cover defines an elongate slot extending along a portion of a length of the cover, and the strap assembly has an indicator identifying the relative location of the strap assembly to the cover. A strap is securable to the strap assembly.

FIELD OF ART

This disclosure relates to a strap tightener assembly for an orthopedicdevice for tightening a strap used to secure the orthopedic device on awearer.

BACKGROUND

Knee braces are widely used to treat a variety of knee infirmities. Suchbraces may be configured to impart forces or leverage on the limbssurrounding the knee joint to relieve compressive forces within aportion of the knee joint, or to reduce the load on that portion of theknee. In the event that knee ligaments are weak and infirm, a knee bracemay stabilize, protect, support, unload, and/or rehabilitate the knee.

The knee is acknowledged as one of the weakest joints in the body, andserves as the articulating joint between the thigh and calf musclegroups. The knee is held together primarily by small but powerfulligaments. Knee instability arising out of cartilage damage, ligamentstrain and other causes is relatively commonplace since the knee jointis subjected to significant loads during the course of almost any kindof physical activity requiring using the legs.

A healthy knee has an even distribution of pressure in both the medialand lateral compartments of the knee. It is normal for a person with ahealthy knee to place a varus moment on the knee when standing so thepressure between the medial and lateral compartments is uneven but stillnatural.

One type of knee infirmity that many individuals are prone to having iscompartmental osteoarthritis. Compartmental osteoarthritis may arisewhen there is a persistent uneven distribution of pressure in one of themedial and lateral compartments of the knee. Compartmentalosteoarthritis can be caused by injury, obesity, misalignment of theknee, or due to aging of the knee.

A major problem resulting from osteoarthritis of the knee is that thesmooth cartilage lining the inside of the knee wears away. This leads toa narrowing of the joint space with developing cysts and erosions in thebone ends. Because of the narrowing of the joint, bone comes directly incontact with bone, and an uneven distribution of pressure developsacross the knee which may cause the formation of bone spurs around thejoint. All of these changes ultimately lead to increasing pain andstiffness of the joint.

While there are no cures to osteoarthritis, there are many treatments.Individuals who have diagnosis of isolated medial or lateralcompartmental osteoarthritis of the knee are confronted with a varietyof treatment options such as medications, surgery, and nonsurgicalinterventions. Nonsurgical interventions include using canes, lateralshoe wedges, and knee bracing.

Knee bracing is useful to provide compartmental pain relief by reducingthe load on the affected compartment through applying an opposingexternal valgus or varus moment about the knee joint. Unloading kneebraces have been shown to significantly reduce osteoarthritis knee painwhile improving knee function.

In these unloading braces, straps fasten the brace to the limb andenable the strap to exert forces on the knee to unload the affectedcompartment of the knee. The tension in a strap affects the function,fit and comfort of the brace, especially when the strap is used tounload the knee. Inadequate tension may diminish the effectiveness ofthe brace to not only unload the knee but to stabilize the brace aswell, whereas excessive tension may cause discomfort to the wearer. Itwould be beneficial to provide a device that indicates how much tensionis in a strap and provide means by which the tension of the strap can beeasily controlled.

The prior art suffers from disadvantages of providing adequate means foridentifying the tension level or tightening in a strap, and rarelyallows for incremental tensioning control of the strap at a plurality ofpredefined settings.

SUMMARY

In an embodiment of the strap tightener assembly, the assembly includesan elongate base having first and second ends, a tightening devicehaving incremental control at a plurality of predefined settings andmounted on the base near the first end and movable relative thereto, anda strap assembly having a first end coupled to the tightening device andmoved linearly relative to the base. The strap assembly carries a strap.An indicator may be provided which allows for a measure of displacementof the strap assembly relative to the base.

The strap tightener assembly may include a cover extending over thestrap assembly and interlockingly connected to the base. The base andthe cover form a channel permitting movement of the strap assemblytherethrough so that the strap assembly carrying the strap may becontained or confined within the channel over its course of movement.

The base may include a housing for receiving the tightening device. Acable may be rotatably secured and windable about the tightening device.The cable secures at one end to the strap assembly and the housingdefines at least one opening along a side for permitting passage of thecable therethrough.

The strap tightener assembly may be considered substantially flexiblehaving at least a majority of its length which can yield to the shape ofa wearer's anatomy as the strap is tightened thereagainst. While somecomponents, such as the tightening device may not be or have lessflexibility than the base and the cover, the strap tightener assemblywhen considered as a whole can flex.

The strap may be formed from a textile and have a width substantiallygreater than a width of the cable. The textile-based strap may have atleast one surface formed from hook receivable material. The strapassembly may include an indicator slidably fitting within an elongateslot of the cover. A plurality of indicia may be located along theelongate slot and the indicator slides relative to the indicia toindicate tension levels of the strap assembly.

The strap assembly and the base may be formed from a flexible polymericmaterial, and the cover may be formed from a flexible polymeric materialor a textile. In a variation, the base is formed from a material harderthan the cover.

The strap tightener assembly may be considered substantially flexiblehaving at least a majority of its length which can yield to the shape ofa wearer's anatomy as the strap is tightened thereagainst. While somecomponents, such as the tightening device may not be or have lessflexibility than the base and the cover, the strap tightener assemblywhen considered as a whole can flex and resiliently return to shape.

According to an embodiment, the cover defines a plurality of openingsalong a back surface, and the base has a plurality of protrusionsinterlockingly engaging the cover at the plurality of openings. Fastenerelements may be on the plurality of protrusions such that the fastenerelements extend outwardly from the strap tightener assembly.

The orthopedic device disclosed may be of an unloading type knee brace,under the principles described in U.S. Pat. No. 7,198,610, granted Apr.3, 2007, and U.S. Pat. No. 5,277,698, granted Jan. 11, 1994, bothincorporated herein in their entirety by reference. The disclosure andthe strap tightener assembly described herein can be employed in avariety of orthopedic devices outside of unloading type knee braces, andthe principles can be yet further extended to any application includingincremental control of a strap.

An additional strap tightener assembly may be used in any part of theorthopedic device, and particular for circumferentially adjusting astrap. A tightening device may be secured on a frame member andadjustably secured to a strap assembly or strap which is connected tothe same frame member or another frame member. By adjusting thetightening device, the strap or strap assembly can be tightened orloosened accordingly. In a variation, the strap assembly includes afirst strap segment secured to a cable retainer and a second strapsegment is adjustably secured to the first strap segment. Substantialadjustments can be made by securing the second strap segment to variouslocations on the first strap segment, or vice versa, and then smalladjustments may be made by the tightening device.

A cable connecting the tightening device to the strap or strap assemblymay be concealed by a sleeve covering at least a portion of the framemember or the cable may extend through portions of the frame member.

BRIEF DESCRIPTION OF THE DRAWINGS

The strap tightener assembly for an orthopedic device is describedreferring to the accompanying drawings which show preferred embodimentsaccording to the device described. The device as disclosed in theaccompanying drawings is illustrated for example only. The elements andcombinations of elements described below and illustrated in the drawingscan be arranged and organized differently to result in embodiments stillwithin the spirit and scope of the device described.

FIG. 1 is a perspective view showing a strap tightener assembly on anorthopedic device.

FIG. 2 is a plan view of an embodiment of a strap tightener assembly.

FIG. 3 is an elevational view of the embodiment of FIG. 2.

FIG. 4 is an exploded view of an embodiment of the strap tightenerassembly.

FIG. 5 is a perspective view of an embodiment of components of the straptightener assembly.

FIG. 6 is a perspective view of another embodiment of the straptightener assembly.

FIG. 7A is a perspective view of another embodiment of the straptightener assembly.

FIG. 7B is a perspective view of yet another embodiment of the straptightener assembly without a strap attached thereto.

FIG. 8A is a plan frontal view of an embodiment of a casing and base fora strap tightener assembly.

FIG. 8B is a rear plan view of the cover in FIG. 8A.

FIG. 8C is a rear plan view of the base in FIG. 8A.

FIG. 8D is a frontal elevational view of the base in FIG. 8A.

FIG. 8E is a plan frontal view of a cable retainer in FIG. 8A.

FIG. 9 is another embodiment of a strap tightener assembly.

FIG. 10 is yet another embodiment of a strap tightener assembly.

FIG. 11 is a perspective view showing an additional strap tightenerassembly on the orthopedic device of FIG. 1.

FIG. 12 is a perspective view showing a rear side of the orthopedicdevice according to FIG. 11.

FIG. 13 is a schematic view showing partial exposure of the additionalstrap tightener assembly of FIG. 11.

FIG. 14 is a variation of the additional strap tightener assembly ofFIG. 13.

DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS A. Overview

A better understanding of different embodiments of the strap tightenerassembly may be had from the following description read in conjunctionwith the accompanying drawings in which like reference characters referto like elements.

While the disclosure is susceptible to various modifications andalternative constructions, certain illustrative embodiments are shown inthe drawings and are described below. It should be understood, however,there is no intention to limit the disclosure to the specificembodiments disclosed, but on the contrary, the intention covers allmodifications, alternative constructions, combinations, and equivalentsfalling within the spirit and scope of the disclosure.

It will be understood that, unless a term is expressly defined in thispatent to possess a described meaning, there is no intent to limit themeaning of such term, either expressly or indirectly, beyond its plainor ordinary meaning.

Any element in a claim that does not explicitly state “means for”performing a specified function, or “step for” performing a specificfunction, is not to be interpreted as a “means” or “step” clause asspecified in 35 U.S.C. §112, paragraph 6.

B. Definitions

For ease of understanding the disclosed embodiments of an orthopedicdevice used as the exemplary application for the strap tightenerassembly, the anterior and posterior portions of the orthopedic deviceare described independently. The anterior and posterior portions of theorthopedic device function together to support and stabilize anatomicalportions of the wearer of the device.

For further ease of understanding the embodiments of an orthopedicdevice as disclosed, a description of a few terms may be necessary. Theterm “proximal” has its ordinary meaning and refers to a locationsituated next to or near the point of attachment or origin or a centralpoint, or located toward the center of the body. Likewise, the term“distal” has its ordinary meaning and refers to a location situated awayfrom the point of attachment or origin or a central point, or locatedaway from the center of the body. The term “posterior” also has itsordinary meaning and refers to a location behind or to the rear ofanother location. Lastly, the term “anterior” has its ordinary meaningand refers to a location ahead of or to the front of another location.

The terms “rigid,” “flexible,” “compliant,” and “resilient” may be usedto distinguish characteristics of portions of certain features of theorthopedic device. The term “rigid” should denote that an element of thedevice is generally devoid of flexibility. Within the context of frameor support members or shells that are “rigid,” it is intended toindicate that they do not lose their overall shape when force isapplied, and in fact they may break if bent with sufficient force. Theterm “flexible” should denote that features are capable of repeatedbending such that the features may be bent into retained shapes or thefeatures do not retain a general shape, but continuously deform whenforce is applied.

The term “compliant” may be used to qualify such flexible features asgenerally conforming to the shape of another object when placed incontact therewith, via any suitable natural or applied forces, such asgravitational forces, or forces applied by external mechanisms, forexample, strap mechanisms. The term “resilient” may be used to qualifysuch flexible features as generally returning to an initial generalshape without permanent deformation. As for the term “semi-rigid,” thisterm may be used to connote properties of support members or shells thatprovide support and are free-standing; however such support members orshells may have some degree of flexibility or resiliency.

C. Various Embodiments of the Strap Tightener Assembly

As illustrated in FIG. 1, an embodiment of a strap tightener assembly 10is described in an exemplary combination with an unloading,osteoarthritic knee brace 11 of a type generally described in U.S. Pat.No. 7,198,610. The description focuses on the structure, materials, andconfiguration of a strap tightener assembly, without belaboring theeffects and modalities for treating osteoarthritis in the knee joint anda brace structure itself.

Turning to FIGS. 1-3, the strap tightener assembly 10 includes a strap12 secured to a strap assembly or tab 14 having an elongateconfiguration by a plurality of stitches 16 or other suitable means. Thetab 14 is slidably connected to a base 18 within a channel formed by thebase 18 and a cover 22. The tab 14 carries a retaining element 24 at oneend portion, such as a protrusion, that slidably engages a slot 28formed by the cover 22. The cover 22 defines indicia 26 along the slot28 to indicate relative tension in the strap 12 with the retainingelement 24 serving as an indicator.

A tightening device 30 is mounted onto the base 18, and engages the tab14. The tightening device 30 includes incremental, rotary movement at aplurality of predetermined settings which allows the strap 12 to beadjusted relative to the base in an incremental and predefined manner.According to this embodiment, a pair of cables 32A, 32B engages the tab14 and the cables are wound or released from the tightening devicepermitting the incremental adjustment of the strap relative to the cover22.

An example of a tightening device is found in U.S. Pat. No. 7,992,261,incorporated in its entirety by reference, and in U.S. Pat. No.7,198,610.

As exemplified in FIG. 1, the base 18 carries a locking or engagingelement 20 which is securable at an opening 36 formed on a frame member34 of the brace 11. According to this exemplary embodiment, the strap 12crosses another strap 40, and both the straps 12, 40 connect to bothupper and lower frame members 34, 38 of the orthopedic device such thatthe straps 12, 40 exert forces F against the knee.

The strap is preferably formed from a textile based material, but can beconstructed from a variety of materials such as polymers andcombinations of polymers and textiles. The tab is preferably constructedfrom a flexible, polymeric material having sufficient rigidity to slidewithin the channel formed by the base and cover. The base is preferablyformed from a polymeric material having greater rigidity than the tab,whereas the cover can be constructed from a polymeric material ortextile. In a preferred embodiment, the base and the cover areinterlockingly secured to one another.

As shown in FIG. 1, the strap tightener assembly may be consideredsubstantially flexible and resilient by having at least a majority ofits length which can yield to the shape of a wearer's anatomy as thestrap is tightened thereagainst. According to FIG. 1, while somecomponents, such as the tightening device may not be or have lessflexibility than the base and the cover, the strap tightener assemblywhen considered as a whole can flex about the leg of the wearer as thestrap is tightened. Upon release of tension, the strap tightenerassembly is sufficiently resilient to return to its previous shape priorto tightening of the strap.

Turning to FIG. 4, a channel 44 is shown as extending between the base18 and the cover 22. According to this embodiment, the cover 22 forms anopening 48 through which a dial 46 of the tightening device 30 secures.The tightening device 30 includes a pin 50 connecting the dial 46 to thebase 18, which forms a housing 42 bearing a series of teeth about itsinner circumferential periphery and for receiving the tightening device46. A detent (not shown) is provided in combination with the dial forengaging the teeth in order to form a ratcheting device. The dial 46 isconfigured to rotate about an axis 62 about which the pin 50 extends sothat the detent engages the teeth.

In FIG. 5, the tightening device 30 includes the two cables 32A, 32Bwhich secure to a cable retainer 52 which has a channel 54 adapted forretaining the cables 32A, 32B. The cable retainer 52 may be secured tothe tab 14, to permit movement of the strap relative to the base, oralternatively, the cable guide 52 is arranged to slide within thechannel formed by the base 18 and a cover 22.

Referring to FIG. 6, another embodiment of the strap tightener assembly10 includes a textile based cover 21 having a reinforced edge 23 aboutthe slot 28. FIG. 6 shows the position of the cable retainer 52 on thebase 18 with the cables 32A, 32B. Also, according to this embodiment, asecond end 57 of the strap 12 is shown as securing against the surfaceof the strap, with the first end 56 secured to the tab 14. The strap 12is merely an intermediate strap coupling a main strap 59 to the straptightener assembly 10. The strap 12 and the main strap 59 are trimmableso as to customize the length of the straps.

According to the embodiments of FIGS. 7A and 7B, the base 18 may havedifferent shapes, as evidenced by the first end portion 58 of the base18 in FIG. 7A, and the first end portion 60 of the base 18 in FIG. 7B.

FIGS. 8A-8D show an embodiment of the strap tightener assembly having aforward or first end portion profile 60 wherein the locking element 20extends substantially at an edge. The housing 42 for the tighteningdevice extends outside of the cover 22, with the pivot point 62 for thetightening device 30 forward the cover 22, such that an arcuate edgeportion 64 of the cover 22 is located near the housing 42 at which thecover 22 forms first and second openings 65 for receiving the cable 32.A cable retainer 78 is secured to the strap 12, and cable 32, as inFIGS. 2 and 5. The cable retainer 78 is coupled to the tightening device30 so the cable retainer 78 can slide within the channel formed by thebase 18 and the cover 22 while carrying the strap 12.

FIG. 8A shows a series of windows 29 of the slot 28 which allows for anindicator 92 formed on the cable retainer 78 to show where the cableretainer 78 is relative to the cover 22. The indicator 92 may beappropriately colored to provide contrast relative to the cover 22, andthe cable retainer 78 is adapted to slide within the channel (i.e., 44in FIG. 4) along the indicia 0-10 or other appropriate range used.

FIGS. 8B-8D show how the cover 22 interlocks with the base 18. The base18 includes a plurality of protrusions 66 on an under side of the base18. Each protrusion 66 extends through openings 68 formed by the cover22, and the protrusions engage edges surrounding the openings 68. Eachprotrusion 66 has a surface 70 upon which fastener elements may besecured so the strap tightener assembly may be secured to a sleevehaving a loop covered surface. Padding 76, such as an elongate strip, ispreferably secured to the underside of the base. For example, thepadding 76 may be only located along the protrusions 66.

FIG. 8D shows the housing 42 as including openings 72, 74 through whichcables connecting to the tightening device extend. Additional openingsand structural features may be formed to guide the cables or permitmounting of additional components to the base.

FIG. 8E illustrates the cable retainer 78 as having a strap extension 80used to secure the strap 12 to the cable retainer 78. The strap may bestitched, adhered or mechanically locked to the strap extension 80. Thestrap extension is preferably formed as a flat, thin portion of thecable retainer having flexibility but preferably more rigidity than thestrap mounted thereon. The strap extension is preferably at least of thesame width as the strap.

Alternatively, the strap may be formed as a single piece with the cableretainer 78, such as by an injection molded construction. The cableretainer 78 also defines a base portion 82 which defines a channel 84for guiding the cable 32 along the cable retainer 78. The channel 84 isrecessed from the base portion 82, and defines opposed holes 86 throughwhich a portion of the cable extends into a base portion 88 of thechannel 84 which secures the cable to the cable retainer 78.

The indicator 92 is provided generally between the holes 86 and isadapted to be visible through the window 29 of the cover 22. The channel84 includes recessed portion relative to the indicator 92 so the cabledoes not interfere with the indicator as the cable retainer is adjustedwithin the channel. The channel 84 is preferably centrally formed withinthe thickness of the cable retainer to maintain stable sliding withinthe channel, however other constructions may be used. The cable retainer78 defines a ledge 90 dividing the base portion 82 from the strapextension 80 to at least in part to stably provide thickness for thebase portion 82 with the cable, and allow for the strap extension 80 tohave flexibility in combination with the strap 12.

The cable retainer is arranged to slide within the channel formed by thebase and the sleeve to preferably maintain the cables within thechannel, confining them to be covered by the sleeve. This arrangement isadvantageous in that the user is not exposed to the cables which may becaught by objects. The windows of the slot preferably extend between thecables to again protect the cables from outside objects.

Preferably the base, cable, and cable retainer are inelastic and thestrap itself, particularly when used in the embodiment of anosteoporosis knee brace. While the base or other components may beflexible, this is not to be confused with elastic which connotesstretching in length as opposed to bending as in flexible.Alternatively, however, the base may have some elasticity versus thestrap, and any combination of the components and strap may be inelasticor elastic with varying degrees relative to one another.

The strap tightener of FIGS. 8A-8E is preferably arranged to yield tothe shape of the leg or other anatomical portion of the wearer. Althoughsome components by themselves may not be flexible, such as thetightening device 30, other parts may be flexible including the base andthe cover, and at least portions of the cable retainer such as the strapextension.

In observing FIG. 9, yet another embodiment of a strap tightenerassembly 100 is illustrated. According to this embodiment, the assembly100 couples first and second strap segments 102, 104. The first strapsegment 102 may secure to the cover 108 in a stationary manner. Theassembly 100 includes a tightening device 106 that couples to the secondstrap segment 104 to allow adjustment of the second strap segment 104relative to the cover 108. The cover 108 has a slot opening 114 formedabout a central region or base area 112. A plurality of indicia 116 arelocated along the slot opening 114, and an indicator 110 is connected tothe second strap segment 104 to enable an indication of travel of thesecond strap segment 104 relative to the cover 108.

Preferably the cover 108 includes padding on an underside to provide acomfortable interface against the wearer. The cover 108 may be flexibleto yield to the anatomy of the wearer. The cover may likewise be formedfrom a rigid or semi-rigid material according to other applications.

The first strap segment 102 may engage the tightening device so turningor adjustment of the tightening device may cause both or only one of thefirst and second strap segments to travel relative to the cover.

A stripe or marking 118 may be added to the face of the cover 108 alongthe scale 116 to provide a marker for how much the tightening deviceshould be tightened. According to a variation, the cover may be formedor covered with a hook-receivable material which allows adjustment inlocation of the stripe which has hook-type material. In an alternativevariation, the cover may have a markable surface that permits aclinician to mark with a pen the appropriate location. In eachvariation, however, while not limited, it is desirable that the markingcan be adjusted during treatment. Additional markings may be provided atany time which allows the clinician to set up “scaling over time”permitting the wearer to remove the marking after a level of treatmentis completed.

Turning to FIG. 10, the strap tightener assembly may include a colorscale 122 with an indicator 120 corresponding to the color scale. As analternative to the marking located alongside the scale 122, a marker 124may apply to the scale 122 itself to indicate a certain tighteninglevel.

In reference to FIG. 11, an additional strap tightener assembly 210 maybe used in any part of the orthopedic device 200, and particular forcircumferentially adjusting a strap. A tightening device 232 may besecure on a frame member 212 and adjustably secure to a strap assemblyor a strap 220 which is connected to the same frame member 212 oranother frame member 214. By adjusting the tightening device 232, thestrap assembly or the strap 220 can be tightened or loosenedaccordingly.

FIGS. 12 and 13 depict a variation of the strap assembly 220 includes afirst strap segment 222 secured to a cable retainer 236 which connectsto a cable 238 engaging the tightening device 216, and a second strapsegment 224 is adjustably secured to the first strap segment 222.Substantial adjustments can be made by securing the second strap segment224 to various locations on the first strap segment 222, or vice versa,and then small adjustments may be made by the tightening device 216 suchthat either the first and second strap segments have corresponding hookand loop fastening elements, or equivalent fastening elements.

The first and second strap segments are detachably secured to oneanother by locking elements. For example, strap segment 222 has a hookreceivable surface, and the second strap segment 224 has a hook tab 240engageable over the hook receivable surface. The first and second strapsegments may be constructed from different materials and havingdifferent properties such as being elastic, inelastic and varyingdegrees therebetween.

In reference to FIG. 12, the second strap segment 224 adjustably securesto a bracket 226 having a fastening element 228 which is engageable withan opening 230 formed on a first side of the frame member 212. The strapassembly 220 extends generally from a second side of the frame memberand connects to the first side to form a circumferential attachment fora leg of a wearer. A diagonal or supplementary strap 218 may likewise besecured to the bracket 226 under orthopedic device embodimentsincorporated by reference.

The first or the second strap segments may have different elasticitiesor be wholly inelastic. The first strap segment may be inelastic,whereas the second strap segment may be elastic. This allows for sometensioning relief on the leg of the wearer, particularly since thesecond strap segment may be substantially longer than the first strapsegment which may not reach beyond or reaches minimally beyond the firstframe member periphery. This allows for most of the circumferentialdistance between the first and second sides of the frame member to bespanned by the elastic second strap segment. The lack of elasticity ofthe first strap segment is advantageous since it carries the cableretainer.

It follows from this embodiment that small adjustments in tightening canbe achieved after the strap assembly is secured to the wearer's leg. Theelasticity of the second strap segment allows for compensation of theleg as it goes between flexion and extension. This arrangement will alsoaccommodate a variety of leg circumferences.

Because most adjustment of the strap assembly is achieved by adjustingthe second strap segment relative to the first strap segment, and theattachment of the bracket to the frame member, the strap assembly can befine tuned by the wearer but not outside of a range of initial fittingof the strap assembly by the methods associated between the first andsecond strap segments and the bracket discussed above, and the length ofthe cable. This allows for the wearer to make adjustments without havingto tinker with the strap assembly and the bracket, and permits thepractitioner to set the length of the strap assembly without the needfor the wearer to make later adjustments, other than by the tighteningdevice.

FIGS. 11 and 13 show that a sleeve 234 may be provided over at least aportion of the frame member. The sleeve protects the cable and preventsthe cable from catching on environmental items.

Turning to the embodiment of FIG. 14, the cable 238 connecting thetightening device 216 may be concealed by at least a portion of theframe member 212 or the cable may extend through portions 242 of theframe member 212.

While the foregoing embodiments have been described and shown,alternatives and modifications of these embodiments, such as thosesuggested by others, may be made to fall within the scope of thedisclosure. Any of the principles described may be extended to any otherorthopedic devices or other types of articles requiring similarfunctions of those structural elements described.

1. A strap tightener assembly, the assembly comprising: a flexible baseformed from a polymeric material having first and second ends; atightening device mounted on the base near the first end and movablerelative thereto, the tightening device arranged for incrementallywinding a cable extending therefrom at a plurality of predefinedsettings, the cable having a first end coupled to the tightening deviceand arranged to move linearly relative to the base from the second endto the first end by adjustment of the tightening device; a strap formedfrom a textile and having a first end connected to the second end of thecable; a cover extending over the strap assembly and connected to thebase, the base and the cover forming a channel permitting movement ofthe cable and the first end of the elongate strap therethrough.
 2. Thestrap tightener assembly according to claim 1, wherein the cover isformed from a flexible, polymeric material.
 3. The strap tightenerassembly according to claim 2, wherein the cable is confined to movementwithin the channel.
 4. The strap tightener assembly according to claim3, wherein the cable is rotatably secured and windable about thetightening device, and extends substantially only within the channel. 5.The strap tightener assembly according to claim 4, further comprising acable retainer secured to the cable and the strap is mounted to thecable retainer.
 6. The strap tightener assembly according to claim 5,wherein the cable retainer includes a flat and flexible strap extensionhaving more rigidity than the strap, the strap extension havinggenerally the same width as the strap.
 7. The strap tightener assemblyaccording to claim 1, wherein the base includes an engaging elementprotruding from the first end thereof.
 8. The strap tightener assemblyaccording to claim 1, wherein the cover defines an elongate slotextending along a portion of a length of the cover, the strap assemblyhaving an indicator identifying the relative location of the strapassembly to the cover and visually apparent through the elongate slot.9. The strap tightener assembly according to claim 8, wherein theindicator slidably fits within the elongate slot of the cover.
 10. Thestrap tightener assembly according to claim 9, wherein the coverincludes a plurality of indicia representing a scale along a path whichthe indicator slides relative to the cover.
 11. The strap tightenerassembly according to claim 10, wherein the cover defines a plurality ofopenings along a back surface thereof, the base having a plurality ofprotrusions interlockingly engaging the cover at the plurality ofopenings.
 12. The strap tightener assembly according to claim 1, whereinthe strap comprises a first strap segment secured to the strap assembly,and a second strap segment detachably secured to the first strap segmentby a plurality of locking elements.
 13. A strap tightener assembly, theassembly comprising: a base having first and second ends; a tighteningdevice mounted on the base near the first end and movable relativethereto, the tightening device having incremental control at a pluralityof predefined settings; a strap assembly having a first end coupled tothe tightening device and arranged to move linearly relative to the basefrom the second end to the first end by adjustment of the tighteningdevice, the strap assembly including a strap formed from a textilematerial; a cover extending over the strap assembly and connected to thebase, the base and the cover forming a channel permitting movement ofthe strap assembly therethrough, the cover defining an elongate slotextending along a portion of a length of the cover, the strap assemblyhaving an indicator identifying the relative location of the strapassembly to the cover and the indicator being positioned within theelongate slot.
 14. The strap tightener assembly according to claim 13,wherein the indicator slidably fits within the elongate slot of thecover.
 15. The strap tightener assembly according to claim 13, whereinthe cover includes a plurality of indicia representing a scale along apath which the indicator slides.
 16. The strap tightener assemblyaccording to claim 13, further comprising a cable rotatably secured andwindable about the tightening device, the cable securing to the firstend to the strap assembly.
 17. A strap tightener assembly, the assemblycomprising: a base being flexible and having first and second ends; atightening device rotatably mounted on the base near the first end andmovable relative thereto, the tightening device having incrementalcontrol at a plurality of predefined settings; a strap assembly having afirst end coupled to the tightening device and arranged to move linearlyrelative to the base from the second end to the first end by adjustmentof the tightening device; a cover having first and second ends with thefirst end facing the tightening device and the second receiving thestrap assembly, the cover extending over the strap assembly andconnected to the base, the base and the cover forming a channelpermitting movement of the strap assembly therethrough, the coverdefining an elongate slot extending along a portion of a length of thecover, the strap assembly having an indicator identifying the relativelocation of the strap assembly to the cover; a cable rotatably securedand windable about the tightening device, the cable securing to thefirst end to the strap assembly; wherein the strap assembly furthercomprises a cable retainer secured to the cable and the strap assemblyis mounted to the cable retainer, the cable retainer defining first andsecond holes and a channel through which the cable extends, the cableretainer arranged to slide and be maintained within the channel formedbetween the cover and the base.
 18. The strap tightener assemblyaccording to claim 17, wherein the indicator slidably fits within theelongate slot of the cover.
 19. The strap tightener assembly accordingto claim 17, wherein the cover includes a plurality of indiciarepresenting a scale along a path which the indicator slides.
 20. Thestrap tightener assembly according to claim 17, wherein the strapassembly includes a strap formed from a textile material and having anelongate shape.